Hip Pain

Hip pain refers to any generic pain around the hip joint. In fact, hip pain is not always felt directly as coming from the joint itself and can be experienced in the upper thigh, the groin, or even the knee. Moreover, hip pain may reflect an issue in the back rather than in the joint itself. Hip pain can arise from a variety of factors.

Causes

Hip pain can be sudden or chronic and may occur due to trauma or without an apparent cause. Hip fractures are one of the main and most serious causes of sudden hip pain after a fall. This type of fracture becomes more common with age because bones become more fragile due to osteoporosis, and older individuals are more prone to falls. Among the causes of chronic pain, osteoarthritis is the most common in the adult population. In younger individuals, muscle pain or impingement injuries are by far the most common.

What is osteoarthritis?

Osteoarthritis is the most common joint disease in the world, affecting about 9-10 million Italians. In Western countries, it is one of the most frequent causes of pain, disability, and loss of function in the limbs among adults. Osteoarthritis is primarily characterized by the destruction of cartilage within the joint. As the cartilage wears away, it no longer protects the bone surfaces, which begin to rub against each other, causing pain. Arthritis can also occur as a result of trauma and is referred to as post-traumatic arthritis in this case. This condition, if it reaches an advanced stage and cannot be managed with medication, physical activity, and lifestyle changes, is treated with total hip replacement.

What are the other possible causes of hip pain?

Rheumatoid arthritis, septic arthritis, and other less common forms of arthritis.

Avascular necrosis of the femoral head.

Bursitis is a common cause and is due to inflammation of the trochanteric bursa, a structure that helps reduce friction between the femur and the gluteal muscles. Bursitis is characterized by chronic, intermittent pain on the outer side of the thigh. The pain occurs when walking, rising from a seated position, climbing stairs, and during driving.
Impingement syndrome is another possible cause of pain in younger individuals and athletes. This syndrome is also known as femoroacetabular impingement (FAI) and is a condition in which the bony parts of the hip have an abnormal shape. Since they do not fit together perfectly, the neck and head of the femur rub against the edge of the acetabulum (the cup-shaped bony part that forms the other side of the hip joint), causing pain. During this continuous rubbing, the edge of the acetabulum (labrum) can become damaged, leading to pain as well.This condition could, over time, lead to hip osteoarthritis. It can be treated with surgery when indicated.

Avascular necrosis of the femoral head is another less common condition.

Avascular necrosis of the femoral head is a progressive disease that affects the femoral head and often leads to its complete collapse, resulting in pain, disability, and loss of function. When this condition reaches an advanced stage that cannot be managed with pain medications and other therapies, it is treated with surgery to reduce pain and attempt to regain more functionality.

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